BMC Anesthesiology最新文献

{"title":"Efficacy and safety of hydromorphone caudal block combined with intercostal nerve block during VATS: a single-center randomized controlled study.","authors":"Xianghua Cao, Qiangjun Gui, Pengfei Li, Haoran Yan, Zhiyong Chen, Yujiao Wei, Shujuan Zhang, Wen Yang, Xueping Li","doi":"10.1186/s12871-025-03307-4","DOIUrl":"https://doi.org/10.1186/s12871-025-03307-4","url":null,"abstract":"","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"433"},"PeriodicalIF":2.6,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12395637/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144942844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Decreased renal or cerebral oxygen saturation increases the risk of cardiac surgery-associated acute kidney injury in adult patients: a prospective observational study.","authors":"Bo Wang, Hui Shi, Hua Zhang, Yongjie Chen, Shen Liu, Bin Li, Chunxia Shi","doi":"10.1186/s12871-025-03296-4","DOIUrl":"https://doi.org/10.1186/s12871-025-03296-4","url":null,"abstract":"<p><strong>Objective: </strong>To determine the relationship between intraoperative decreased renal and cerebral oxygen saturation, as measured using near-infrared spectroscopy (NIRS), and cardiac surgery-associated acute kidney injury (CSA-AKI) in adults.</p><p><strong>Methods: </strong>This prospective observational study was conducted at Peking University International Hospital. Between November 2022 to August 2023, 101 adult patients undergoing cardiac surgery under cardiopulmonary bypass were included. Renal and cerebral tissue oxygen saturation was continuously monitored during the operation using NIRS.</p><p><strong>Results: </strong>The overall incidence of CSA-AKI was 27% (27/101), with a 4% incidence rate of requiring renal replacement therapy. The incidence of CSA-AKI was 57% (13/23) in patients with renal desaturation compared to 18% (14/78) in those without renal desaturation (P < 0.01). CSA-AKI occurred in 71% (12/17) of patients with cerebral desaturation compared to 18% (15/84) in those without cerebral desaturation (P < 0.01). The incidence of CSA-AKI was 100% (7/7) in patients with simultaneous renal and cerebral desaturation. Renal desaturation alone showed a sensitivity of 48%, while the combination of renal and cerebral desaturation demonstrated 100% specificity for predicting CSA-AKI.</p><p><strong>Conclusions: </strong>In adult patients, 27% experience CSA-AKI. Intraoperative renal or cerebral desaturation, as monitored by NIRS, is associated with a higher risk of CSA-AKI, with simultaneous renal and cerebral desaturation which yielded the highest specificity in predicting postoperative AKI.</p><p><strong>Trial registration: </strong>This study has been registered on the Chinese Clinical Trial Registry number (ChiCTR2200065161, 30/10/2022).</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"434"},"PeriodicalIF":2.6,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12395922/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144943328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of sevoflurane-based or propofol-based anesthesia on acute kidney injury after surgery for gastric cancer: a retrospective propensity score-matched analysis.","authors":"Yang Song, Si Liang, Ming Wei, Hong Chen, Liping Wang, Yu Wang","doi":"10.1186/s12871-025-03330-5","DOIUrl":"https://doi.org/10.1186/s12871-025-03330-5","url":null,"abstract":"<p><strong>Background: </strong>Acute kidney injury (AKI) is a common complication of major abdominal surgery that is associated with adverse patient outcomes including death. The objective of this study was to investigate the incidence of postoperative AKI after gastric cancer surgery, comparing patients who received propofol-based TIVA with those who received sevoflurane-based INHA.</p><p><strong>Methods: </strong>We analyzed the medical records of all patients aged 19 years or older who underwent radical surgery for primary gastric cancer at the Harbin Medical University Cancer Hospital between January 2010 and September 2018. After propensity score matching, the incidence of AKI in the first 3 postoperative days was compared between patients who received propofol and those who received sevoflurane.</p><p><strong>Results: </strong>3533 patients were included in the study. After propensity score matching, 1206 patients were assigned to each group. The logistic regression analysis showed that the incidence of AKI was not different in the two groups before (OR 1.05, 95% CI 0.80 to 1.38, P = 0.731) and after propensity score matching (OR 1.02, 95% CI 0.71 to 1.47, P = 0.926). Before propensity score matching, acute kidney injury occurred in 146 sevoflurane and 85 propofol patients. The overall incidence was 6.4% in the sevoflurane group and 6.7% in the propofol group. After propensity score matching, acute kidney injury occurred in 60 sevoflurane and 61 propofol patients. The overall incidence was 5.0% in the sevoflurane group and 5.1% in the propofol group.</p><p><strong>Conclusion: </strong>In this retrospective study, no significant difference was found in the incidence of postoperative AKI after gastrectomy between patients who received propofol-based TIVA and those who received sevoflurane-based INHA in this retrospective study.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"429"},"PeriodicalIF":2.6,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12382286/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144943302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perioperative management of intracranial-extracranial communicating tumors with multidisciplinary combined surgery: a case series.","authors":"Xiaoxiao Zhang, Liu Yang, Wenhao Wu, Ruquan Han, Haiyang Liu","doi":"10.1186/s12871-025-03310-9","DOIUrl":"https://doi.org/10.1186/s12871-025-03310-9","url":null,"abstract":"","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"427"},"PeriodicalIF":2.6,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12382093/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144943307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of high-flow nasal oxygen therapy on perioperative hypoxemia in children: a systematic review and meta-analysis.","authors":"Kuangyu Zhao, Yanhong Li, Qian Wang, Jiaqiang Zhang, Jun Zhou","doi":"10.1186/s12871-025-03214-8","DOIUrl":"https://doi.org/10.1186/s12871-025-03214-8","url":null,"abstract":"","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"428"},"PeriodicalIF":2.6,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12382278/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144943339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of epidural dexmedetomidine on post-operative nausea & vomiting in adult patients undergoing abdominopelvic surgery: a randomized controlled study.","authors":"Piyawan Koopredechat, Wanida Chongarunngamsang, Manita Kaweewong, Nattamon Thitipanichayankul, Salinee Poonjan, Thanyalak Chanakul","doi":"10.1186/s12871-025-03324-3","DOIUrl":"10.1186/s12871-025-03324-3","url":null,"abstract":"<p><strong>Background: </strong>The incidence of postoperative nausea and vomiting (PONV) has been reported to reach as high as 33.5% in patients undergoing abdominal surgeries. Intravenous dexmedetomidine has been shown to be effective in reducing the incidence of PONV, possibly through the inhibition of catecholamine release and decreased opioid requirements. This study aims to investigate the potential efficacy of epidural dexmedetomidine in preventing PONV in patients undergoing abdominal and pelvic surgery under combined general-epidural anesthesia.</p><p><strong>Methods: </strong>The study enrolled patients aged 18-65 years with an ASA physical status I-III who were scheduled for elective open abdominal or pelvic surgery. Patients were randomized to receive either a single bolus dose of dexmedetomidine during peritoneal closure or placebo. No additional PONV prophylaxis was provided. Patients in the dexmedetomidine group received 2 mg of morphine combined with dexmedetomidine 1 mcg kg^-1 via the epidural catheter, whereas those in the placebo group received only morphine diluted to an equivalent volume.</p><p><strong>Results: </strong>Of the 108 patients randomized between August 2024 to April 2025, 99 were included in the final analysis. The incidence of PONV within 1 and 6 h postoperatively was significantly lower in the dexmedetomidine group compared to placebo (3.8% vs. 30.4%; RR 0.12, 95% CI 0.03-0.52, p < 0.001 and 13.2% vs. 32.6%, RR 0.41, 95% CI 0.18-0.91, p = 0.021), respectively. The severity of postoperative nausea was not different between the groups (p = 0.557). The incidence of postoperative shivering was significantly lower in the dexmedetomidine group (0% vs. 15.2%, p = 0.003).</p><p><strong>Conclusions: </strong>A single administration of epidural dexmedetomidine at 1 mcg kg^-1 significantly reduced both the incidence of early PONV at 1 and 6 h postoperatively and postoperative shivering without increasing hemodynamic complications.</p><p><strong>Clinical trial registration: </strong>Retrospectively registered with Thai Clinical Trials Registry (TCTR20250331001) on 31 March 2025.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"430"},"PeriodicalIF":2.6,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12382251/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144943326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasound-based assessment of muscle mass is associated with early recovery after kidney transplant: a prospective single-center study.","authors":"Nicholas V Mendez, Michael P Bokoch, Dieter Adelmann, Matthew D Bucknor, Elaine Ku, Kerstin Kolodzie","doi":"10.1186/s12871-025-03288-4","DOIUrl":"https://doi.org/10.1186/s12871-025-03288-4","url":null,"abstract":"<p><strong>Background: </strong>Low muscle mass and frailty are associated with worse perioperative outcomes. However, traditional modalities for quantifying muscle mass are limited, costly, may require radiation exposure, and can be unreliable with kidney failure. We hypothesize that ultrasound-measured muscle mass is associated with early recovery metrics after kidney transplant.</p><p><strong>Methods: </strong>In a prospective single center cohort study, we investigated the association between muscle mass and short-term outcomes after kidney transplant. Patients undergoing kidney transplant between November 2019 and October 2020 were enrolled. We quantified muscle mass by ultrasound measurement of the rectus femoris cross-sectional area. The primary outcome was the number of days alive and out of hospital within 30 days of surgery. Incidence of surgical complications by the Clavien-Dindo system was also evaluated.</p><p><strong>Results: </strong>Thirty-eight patients were enrolled with 36 completing kidney transplant. Median cross-sectional area was 4.82cm² [IQR 4.18 to 6.05] and median days alive and out of hospital was 26 [IQR 24 to 27]. Lower muscle mass was associated fewer days alive and out of hospital postoperatively. Cross-sectional area was 4.35cm² [IQR 4.11 to 5.79] versus 5.49cm² [IQR 4.94 to 6.55] for those at or below versus above the median days alive and out of hospital respectively (p = 0.046). Lower muscle mass was associated with occurrence of at least one surgical complication. Cross-sectional area was 4.30cm² [IQR 4.11 to 4.91] versus 5.46cm² [IQR 4.35 to 6.84] for those who did and did not experience a complication respectively (p = 0.024).</p><p><strong>Conclusions: </strong>Lower muscle mass as measured by point-of-care ultrasound was associated with fewer days alive and out of hospital and more surgical complications after kidney transplant. Further studies should explore the role that ultrasound-measured muscle mass can play in guiding the pre-surgical care of patients prior to kidney transplant.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"424"},"PeriodicalIF":2.6,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12379526/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144943290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of intraoperative Electroencephalogram-guided anesthesia on postoperative cognitive function in elderly patients: a systematic review, meta-analysis, and trial sequential analysis of randomized controlled trials.","authors":"Qingtang Yin, Daobing Chen, Chunmiao Gu","doi":"10.1186/s12871-025-03297-3","DOIUrl":"https://doi.org/10.1186/s12871-025-03297-3","url":null,"abstract":"","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"423"},"PeriodicalIF":2.6,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12379316/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144943330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can we improve the existing management of pain after cesarean delivery at Eastern Regional Referral Hospital? A retrospective study.","authors":"Tashi Wangchuk, Ugyen Tshering","doi":"10.1186/s12871-024-02774-5","DOIUrl":"https://doi.org/10.1186/s12871-024-02774-5","url":null,"abstract":"<p><strong>Background: </strong>Pain after surgery is generally considered undertreated worldwide. This may be because of insufficient skills in the management of pain. Inadequate management of pain after cesarean delivery (CD) can adversely affect the well-being of both mothers and newborns, potentially leading to a higher incidence of chronic post-operative pain. This study aimed to review the existing management of pain associated with CD and identify gaps for future improvement in the quality of pain care at Eastern Regional Referral Hospital (ERRH).</p><p><strong>Methods: </strong>This retrospective review of the management of pain after CDs, was conducted between December 2017 and December 2018 at ERRH, Bhutan. A total of 107 CDs were reviewed.</p><p><strong>Results: </strong>Of the 107 patients reviewed, only 2% had received analgesics before surgery, and 20% of them during surgery. The majority of the patients (63%) has received a single injection of diclofenac sodium, followed by oral ibuprofen (56%) on the following day.</p><p><strong>Conclusions: </strong>Despite the availability of resources, the present review revealed that the existing management of pain after CDs was mostly a single-drug therapy, mainly focusing on only post-operative period.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"426"},"PeriodicalIF":2.6,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12382267/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144943364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intraoperative extracorporeal life support in tracheal surgery: a 20-year single-center experience.","authors":"Lin Sun, Liping Xin, Yuwei Qiu, Lingfeng Xu, Xin Chang, Xiaoyu Zhou, Zhen Guo","doi":"10.1186/s12871-025-03285-7","DOIUrl":"https://doi.org/10.1186/s12871-025-03285-7","url":null,"abstract":"<p><strong>Background: </strong>Despite advancements in perioperative management, patients undergoing complex tracheal surgery still face increased risks of morbidity and mortality. Extracorporeal life support (ECLS) can be utilized to maintain hemodynamic and respiratory stability during surgical procedures, but there is currently no evidence-based practice protocol in place. This study seeks to evaluate the safety and benefits of various ECLS modes in critical tracheal surgery and establish a practical protocol for the application of ECLS.</p><p><strong>Methods: </strong>Single center, retrospective, cohort study. This retrospective study collected data on patients who underwent tracheal procedures on ECLS between January 2000 and December 2020. Patients were divided into three groups according to configuration: cardiopulmonary bypass (CPB), modified CPB and extracorporeal membrane oxygenation (ECMO). Baseline characteristics, in-hospital complications, ECLS details, adverse events, and overall survival were assessed and compared between three groups.</p><p><strong>Results: </strong>Over twenty years period, from 462 primary tracheal disease patients, 67 patients were identified from our institutional medical registry as having received CPB, modified-CPB or ECMO during the procedure (26.9%, 22.4% and 50.7% respectively). Heparin free (n = 30, 44.8%) or low dose heparin (n = 17, 26.6%) therapy was frequently utilized in ECMO and modified-CPB group. The Median pump duration of CPB, modified-CPB, VV, and VA ECMO was 43, 64, 139, and 127 min. Anastomotic complications were significantly lower in the VV-ECMO group (7.1%), while the duration of mechanical ventilation was significantly longer in the VA-ECMO group (66, [2-178]). Surgical bleeding was significantly higher in the CPB group (460 ± 73 ml). More patients in the CPB group (9/18) required blood transfusions; however, there was no significant difference in the volume of packed red blood cells between the groups.</p><p><strong>Conclusion: </strong>Despite intraoperative ECLS being rarely used in tracheal and carinal disease, programmed extracorporeal life support with VV-ECMO demonstrated high effectiveness with an acceptable mortality and morbidity rate in high-risk tracheal surgery.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"425"},"PeriodicalIF":2.6,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12379321/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144943252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}